Auditory Spatial Discrimination and Sound Localization in Single-Sided Deaf Participants Provided with a Cochlear Implant.

INTRODUCTION: Spatial hearing is most accurate using both ears, but accuracy decreases in persons with asymmetrical hearing between ears. In participants with deafness in one ear but normal hearing in the other ear (single-sided deafness [SSD]), this difference can be compensated by a unilateral cochlear implant (CI). It has been shown that a CI can restore sound localization performance, but it is still unclear to what extent auditory spatial discrimination can be improved. METHODS: The present study investigated auditory spatial discrimination using minimum audible angles (MAAs) in 18 CI-SSD participants. Results were compared to 120 age-matched normal-hearing (NH) listeners. Low-frequency (LF) and high-frequency (HF) noise bursts were presented from 4°, 30°, and 60° azimuth on the CI side and on the NH side. MAA thresholds were tested for correlation with localization performance in the same participants. RESULTS: There were eight good performers and ten poor performers. There were more poor performers for LF signals than for HF signals. Performance on the CI side was comparable to performance on the NH side. Most difficulties occurred at 4° and at 30°. Eight of the good performers in the localization task were also good performers in the MAA task. Only the localization ability at 4° on the CI side was positively correlated with the MAA at that location. CONCLUSION: Our data suggest that a CI can restore localization ability but not necessarily auditory spatial discrimination at the same time. The ability to discriminate between adjacent locations may be trainable during rehabilitation to enhance important auditory skills.

3D-printed facet-attached optical elements for connecting VCSEL and photodiodes to fiber arrays and multi-core fibers.

Multicore optical fibers and ribbons based on fiber arrays allow for massively parallel transmission of signals via spatially separated channels, thereby offering attractive bandwidth scaling with linearly increasing technical effort. However, low-loss coupling of light between fiber arrays or multicore fibers and standard linear arrays of vertical-cavity surface-emitting lasers (VCSEL) or photodiodes (PD) still represents a challenge. In this paper, we demonstrate that 3D-printed facet-attached microlenses (FaML) offer an attractive path for connecting multimode fiber arrays as well as individual cores of multimode multicore fibers to standard arrays of VCSEL or PD. The freeform coupling elements are printed in situ with high precision on the device and fiber facets by high-resolution multi-photon lithography. We demonstrate coupling losses down to 0.35 dB along with lateral 1 dB alignment tolerances in excess of 10 µm, allowing to leverage fast passive assembly techniques that rely on industry-standard machine vision. To the best of our knowledge, our experiments represent the first demonstration of a coupling interface that connects individual cores of a multicore fiber to VCSEL or PD arranged in a standard linear array without the need for additional fiber-based or waveguide-based fan-out structures. Using this approach, we build a 3 × 25 Gbit/s transceiver assembly which fits into a small form-factor pluggable module and which fulfills many performance metrics specified in the IEEE 802.3 standard.

[Development and evaluation of a simulator for endoscopic sinus surgery]. / Entwicklung und Evaluation eines Simulators für die endoskopische Nasennebenhöhlenoperation.

BACKGROUND: Endoscopic surgical procedures have been established as gold standard in sinus surgery. Challenges for surgical training have been addressed by the use of virtual reality (VR) simulators. To date, a number of simulators have been developed. However, previous studies regarding their training effects investigated only medically pretrained subjects or the time course of training outcomes has not been reported. METHODS: A computer tomography (CT) dataset was segmented manually. A three-dimensional polygonal surface model was generated and textured using original photographic material. Interaction with the virtual environment was performed using a haptic input device. For the investigation of training outcomes with the simulator, the parameters duration and the number of errors were recorded. Ten subjects completed a training consisting of five runs on ten consecutive days. RESULTS: Within the whole exercise period, four subjects reduced the duration of intervention by more than 60%. Four subjects reduced the number of errors by more than 60%. Eight out of 10 subjects showed an improvement with respect to both parameters. On median, the duration of the procedure was reduced by 46 seconds and the number of errors by 191. The statistical analysis between the two parameters showed a positive correlation. CONCLUSION: Our data suggests that training on the FESS-simulator considerably improves the performance even in inexperienced subjects, both in terms of duration and accuracy of the procedure.

Analyzing Longitudinal Data on Singing Voice Parameters of Boys and Girls Aged 8 to 12.5 and Possible Effects of a Music Pedagogical Intervention.

OBJECTIVE: Controlled and randomized study to analyze longitudinal voice data of boys and girls aged 8-12.5, to describe their physiological development and to evaluate the influence of a one-year music pedagogical interventional program focused on the singing voice. METHODS: Singing voice profiles of 116 children (52 boys, 64 girls) aged 8-12.5 years were collected longitudinally at the beginning and the end of the third school year and the end of the fourth school year. 64 of the 116 children received a music pedagogical program during their third school year (interventional group). Maximum and minimum voice intensity, highest and lowest frequency, maximum phonation time (MPT) and Jitter were investigated. RESULTS: In two years' time highest frequency increased on average by 100.23 Hz from G1 up to A1 for boys and for girls. Lowest frequency decreased by 18.36Hz from Gis-1 to G-1 (boys: Gis-1-Fis-1; girls: A-1-G-1). There was no clinically relevant development of the intensity parameters for both sexes. However, after the interventional year, minimum voice intensity significantly decreased in the interventional group compared to the control group. The MPT increased by 2.41 seconds from 10.67 seconds up to 13.09 seconds in two years. Here the increase was higher for boys (+3.2 seconds) than for girls (+1.77 seconds). Jitter was found to be 0.84%-1.11%, showing no clinically relevant changes in two years. CONCLUSION: To the best of our knowledge, for the first time this study presents longitudinal data on singing voice parameters of the voice range profile of boys and girls aged 8-12.5 years. While frequency and intensity parameters develop equally for boys and girls, the MPT is found to develop more distinctly within boys. A music pedagogical intervention of a small extent has a positive effect on the ability to sing as soft as possible.

Sound Localization in Single-Sided Deaf Participants Provided With a Cochlear Implant.

Spatial hearing is crucial in real life but deteriorates in participants with severe sensorineural hearing loss or single-sided deafness. This ability can potentially be improved with a unilateral cochlear implant (CI). The present study investigated measures of sound localization in participants with single-sided deafness provided with a CI. Sound localization was measured separately at eight loudspeaker positions (4°, 30°, 60°, and 90°) on the CI side and on the normal-hearing side. Low- and high-frequency noise bursts were used in the tests to investigate possible differences in the processing of interaural time and level differences. Data were compared to normal-hearing adults aged between 20 and 83. In addition, the benefit of the CI in speech understanding in noise was compared to the localization ability. Fifteen out of 18 participants were able to localize signals on the CI side and on the normal-hearing side, although performance was highly variable across participants. Three participants always pointed to the normal-hearing side, irrespective of the location of the signal. The comparison with control data showed that participants had particular difficulties localizing sounds at frontal locations and on the CI side. In contrast to most previous results, participants were able to localize low-frequency signals, although they localized high-frequency signals more accurately. Speech understanding in noise was better with the CI compared to testing without CI, but only at a position where the CI also improved sound localization. Our data suggest that a CI can, to a large extent, restore localization in participants with single-sided deafness. Difficulties may remain at frontal locations and on the CI side. However, speech understanding in noise improves when wearing the CI. The treatment with a CI in these participants might provide real-world benefits, such as improved orientation in traffic and speech understanding in difficult listening situations.

[Auditory localisation in hearing impaired schoolchildren with and without hearing aids]. / Die Lokalisationsfähigkeit schwerhöriger Schulkinder mit und ohne Hörgeräte.

OBJECTIVE: Auditory localisation is part of central auditory processing. The study examined the impact of hearing aids on the auditory localisation ability of non-linguistic stimuli in hearing impaired schoolchildren. PATIENTS AND METHODS: Above threshold acoustic signals were presented to 20 children (7-17 years) in a free field condition with 45 loudspeakers placed on a semicircular array. All participants had a bilaterally symmetric moderate sensorineural hearing loss (WHO grade 2) and used behind the ear style (BTE) hearing aids with conventional earmolds. The children had to indicate the position of the signal by a laser pointer. Both high- and low-frequency noise bursts were employed in the tests to separately address spatial auditory processing based on interaural time differences and interaural intensity differences. The examination was performed with and without BTE hearing aids. RESULTS: There was no significant difference between results in the aided and the unaided condition: neither for the different frequency bands nor for the signal positions. The auditory localisation of the hearing impaired children was reduced by 3°-4° for frontal and 5°-11° for lateral positions compared to normal-hearing children. There was no age-relation. CONCLUSIONS: In our experimental setting, BTE hearing aids could not compensate the impaired auditory localisation ability of children with sensorineural hearing loss.

Auditory localization accuracy and auditory spatial discrimination in children with auditory processing disorders.

The present study investigated spatial hearing in children aged 6-12 years diagnosed with Auditory Processing Disorders (APD) and compared their results to those of a group of control children matched in age. Sound source localization accuracy was quantified using an absolute localization task and sound source discrimination by measuring the minimum audible angle. Low- and high-frequency noise bursts were presented from eight loudspeaker positions in the left and right hemifields (0°, 30, 60°, and 90° azimuth). Median absolute localization accuracy did not differ between children with APD and control children. However, the intra-individual variability of pointing behavior was higher for children with APD. In contrast, children with APD had significantly higher minimum audible angle thresholds than control children. These findings show that APD impairs sound source discrimination, but does not affect the median relationship between actual and judged sound source locations.

Temporal Sensitivity Measured Shortly After Cochlear Implantation Predicts 6-Month Speech Recognition Outcome.

OBJECTIVES: Psychoacoustic tests assessed shortly after cochlear implantation are useful predictors of the rehabilitative speech outcome. While largely independent, both spectral and temporal resolution tests are important to provide an accurate prediction of speech recognition. However, rapid tests of temporal sensitivity are currently lacking. Here, we propose a simple amplitude modulation rate discrimination (AMRD) paradigm that is validated by predicting future speech recognition in adult cochlear implant (CI) patients. DESIGN: In 34 newly implanted patients, we used an adaptive AMRD paradigm, where broadband noise was modulated at the speech-relevant rate of ~4 Hz. In a longitudinal study, speech recognition in quiet was assessed using the closed-set Freiburger number test shortly after cochlear implantation (t0) as well as the open-set Freiburger monosyllabic word test 6 months later (t6). RESULTS: Both AMRD thresholds at t0 (r = -0.51) and speech recognition scores at t0 (r = 0.56) predicted speech recognition scores at t6. However, AMRD and speech recognition at t0 were uncorrelated, suggesting that those measures capture partially distinct perceptual abilities. A multiple regression model predicting 6-month speech recognition outcome with deafness duration and speech recognition at t0 improved from adjusted R = 0.30 to adjusted R = 0.44 when AMRD threshold was added as a predictor. CONCLUSIONS: These findings identify AMRD thresholds as a reliable, nonredundant predictor above and beyond established speech tests for CI outcome. This AMRD test could potentially be developed into a rapid clinical temporal-resolution test to be integrated into the postoperative test battery to improve the reliability of speech outcome prognosis.

Localization and Spatial Discrimination in Children and Adolescents with Moderate Sensorineural Hearing Loss Tested without Their Hearing Aids.

The present study investigated two measures of spatial acoustic perception in children and adolescents with sensorineural hearing loss (SNHL) tested without their hearing aids and compared it to age-matched controls. Auditory localization was quantified by means of a sound source identification task and auditory spatial discrimination acuity by measuring minimum audible angles (MAA). Both low- and high-frequency noise bursts were employed in the tests to separately address spatial auditory processing based on interaural time and intensity differences. In SNHL children, localization (hit accuracy) was significantly reduced compared to normal-hearing children and intraindividual variability (dispersion) considerably increased. Given the respective impairments, the performance based on interaural time differences (low frequencies) was still better than that based on intensity differences (high frequencies). For MAA, age-matched comparisons yielded not only increased MAA values in SNHL children, but also no decrease with increasing age compared to normal-hearing children. Deficits in MAA were most apparent in the frontal azimuth. Thus, children with SNHL do not seem to benefit from frontal positions of the sound sources as do normal-hearing children. The results give an indication that the processing of spatial cues in SNHL children is restricted, which could also imply problems regarding speech understanding in challenging hearing situations.

Stacked modulation formats enabling highest-sensitivity optical free-space links.

A new modulation scheme with a sensitivity of 2.3 photons per bit at a bit-error ratio (BER) of 10(-3) is discussed theoretically and demonstrated experimentally. We achieve a limiting sensitivity of 2.3 photons per bit (3.7 dB photons per bit) by stacking the modulation formats 64PPM, 4FSK and polarization-switched (PS) QPSK. This modulation stack encodes 11 bit per symbol (PPM: 6 bit, FSK: 2 bit, PS-PQSK: 3 bit). We also replaced 4FSK by 2ODFM (2-channel multiplex) for comparison. With 64PPM-2OFDM-PS-QPSK a total of 12 bit are encoded (PPM: 6 bit, 2 OFDM channels with PS-QPSK: 2 × 3 bit). Both modulation stacks show a similar limiting sensitivity and are probably the highest sensitivities so far reported for a BER of 10(-3), Our theoretical considerations are supported by simulations and experiments.

Age-related changes in sound localisation ability.

Auditory spatial processing is an important ability in everyday life and allows the processing of omnidirectional information. In this review, we report and compare data from psychoacoustic and electrophysiological experiments on sound localisation accuracy and auditory spatial discrimination in infants, children, and young and older adults. The ability to process auditory spatial information changes over lifetime: the perception of the acoustic space develops from an initially imprecise representation in infants and young children to a concise representation of spatial positions in young adults and the respective performance declines again in older adults. Localisation accuracy shows a strong deterioration in older adults, presumably due to declined processing of binaural temporal and monaural spectro-temporal cues. When compared to young adults, the thresholds for spatial discrimination were strongly elevated both in young children and older adults. Despite the consistency of the measured values the underlying causes for the impaired performance might be different: (1) the effect is due to reduced cognitive processing ability and is thus task-related; (2) the effect is due to reduced information about the auditory space and caused by declined processing in auditory brain stem circuits; and (3) the auditory space processing regime in young children is still undergoing developmental changes and the interrelation with spatial visual processing is not yet established. In conclusion, we argue that for studying auditory space processing over the life course, it is beneficial to investigate spatial discrimination ability instead of localisation accuracy because it more reliably indicates changes in the processing ability.

Auditory processing disorders with and without central auditory discrimination deficits.

Auditory processing disorder (APD) is defined as a processing deficit in the auditory modality and spans multiple processes. To date, APD diagnosis is mostly based on the utilization of speech material. Adequate nonspeech tests that allow differentiation between an actual central hearing disorder and related disorders such as specific language impairments are still not adequately available. In the present study, 84 children between 6 and 17 years of age (clinical group), referred to three audiological centers for APD diagnosis, were evaluated with standard audiological tests and additional auditory discrimination tests. Latter tests assessed the processing of basic acoustic features at two different stages of the ascending central auditory system: (1) auditory brainstem processing was evaluated by quantifying interaural frequency, level, and signal duration discrimination (interaural tests). (2) Diencephalic/telencephalic processing was assessed by varying the same acoustic parameters (plus signals with sinusoidal amplitude modulation), but presenting the test signals in conjunction with noise pulses to the contralateral ear (dichotic(signal/noise) tests). Data of children in the clinical group were referenced to normative data obtained from more than 300 normally developing healthy school children. The results in the audiological and the discrimination tests diverged widely. Of the 39 children that were diagnosed with APD in the audiological clinic, 30 had deficits in auditory performance. Even more alarming was the fact that of the 45 children with a negative APD diagnosis, 32 showed clear signs of a central hearing deficit. Based on these results, we suggest revising current diagnostic procedure to evaluate APD in order to more clearly differentiate between central auditory processing deficits and higher-order (cognitive and/or language) processing deficits.

Age-related dissociation of sensory and decision-based auditory motion processing.

Studies on the maturation of auditory motion processing in children have yielded inconsistent reports. The present study combines subjective and objective measurements to investigate how the auditory perceptual abilities of children change during development and whether these changes are paralleled by changes in the event-related brain potential (ERP). We employed the mismatch negativity (MMN) to determine maturational changes in the discrimination of interaural time differences (ITDs) that generate lateralized moving auditory percepts. MMNs were elicited in children, teenagers, and adults, using a small and a large ITD at stimulus offset with respect to each subject's discrimination threshold. In adults and teenagers large deviants elicited prominent MMNs, whereas small deviants at the behavioral threshold elicited only a marginal or no MMN. In contrast, pronounced MMNs for both deviant sizes were found in children. Behaviorally, however, most of the children showed higher discrimination thresholds than teens and adults. Although automatic ITD detection is functional, active discrimination is still limited in children. The lack of MMN deviance dependency in children suggests that unlike in teenagers and adults, neural signatures of automatic auditory motion processing do not mirror discrimination abilities. The study critically accounts for advanced understanding of children's central auditory development.